HEPATOTOXIC SIDE-EFFECTS OF ANTIRHEUMATIC DRUGS AND ANTIRHEUMATIC TREATMENT IN PREEXISTING LIVER-DAMAGE

In about 1% of patients treated longterm with nonsteroidal antiinflamm atory drugs severe liver damage occurs with an increase of transaminas es of more than eightfold. Therefore, measurement of the liver enzymes every 4 to 8 weeks is mandatory. When the transaminase values are gre ater than 60 U/l, the therapy must be discontinued. Methotrexate may a lso induce an increase of the transaminases, especially within the fir st 3 months of therapy. Severe hepatotoxicity, however, rarely occurs. Therefore, transient increases up to 60 U/l may be tolerable, but per sistent transaminases higher than 60 U/l require termination of methot rexate therapy.